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March 24, 2005

Terri Schiavo and The Right to Die

The media circus and political posturing around the pathetic pictures of poor Terri Schiavo are a disgrace.  There is an important issue here but it isn’t whether Terri Schiavo should be starved to death.  Of course she shouldn’t.  If she has chosen to die rather than be on “life support”, then she ought to be able to die painlessly and with dignity.

I don’t know what choice Ms. Schiavo made prior to not being able to articulate any choice at all.  There seem to have been more-than-thorough  court hearings which established that she didn’t want to have her body kept alive when her brain is dead.  It is a tragedy and a problem when a family disagrees. It would be simpler if she’d left a living will.  But the real issue is that we all ought to have the right to die by some means that are less barbaric than removing water and feeding tubes.  That is the discussion we should be having.

A family member of mine was taken off life support.  In this case there was no family disagreement and it was clear that it would have been even crueler to prolong a terrible quality of life than to end it.  But his end was unnecessarily scary and painful because, as a society, we won’t face the question of giving people the means to die quickly and painlessly.

By contrast, when my old dog’s life became painful to her, we took her to the vet who gave her a lethal injection and I don’t think she was even frightened as she died in my arms.  I wouldn’t compare dogs to people except that we have denied people the ease and decency in death which we grant dogs.

Many health care workers have told me confidentially that they honor family requests for a painless end by increasing a morphine drip until it is fatal.  It is unconscionable that we should put the health care workers in a position of risking their careers and their freedom because we won’t deal politically with this issue.

The issue of who gets to make the decision is very important with people. King Lear would not have wanted his daughters to decide when his “quality of life” wasn’t worth preserving.  More loving family members than the elder Lear girls may make a decision based on how painful it is for them to watch a loved one suffer rather than on what the patient may want.   I think I get to decide about me.  I’m not a dog.  But, to complicate matters, like Ms. Schiavo, I may not be in a position to articulate the choice when the need arises.

Here’s what I think we need to do legally:

  1. Clearly grant the right to die to adults as well as access to the means.  I hate to say that a creep like Dr. Kervorkian is right but he is. (note that I’m not saying that individuals should lightly make the decision to leave if the going gets rough; I’m just saying it’s not a government decision.)
  2. Establish a simple way to establish this choice beyond legal challenge.
  3. Set up a default priority list of which relatives get to make the decision in the case where the patient cannot make the decision AND hasn’t left his or her own list.  We already have a mechanism like this for deciding inheritance if someone dies without a traditional will.

By the way, under the US Constitution, none of this is a federal issue.  It is ironic that many of the same people who say they object to Roe v. Wade because it is a federal intrusion into a state issue are for federal preemption in the Terri Schiavo case and vice versa.

As individuals, we really do need to make living wills and specify who makes the decision for us in a case not covered by our living will.

Just to be clear, here’s what I’d like if I seem irreparable.  Unless I say otherwise, I don’t want to be put to death or to taken off life support but I want my family to treat me as if already dead.  I don’t want to doom them to attending my bedside or being married to a corpse.

I do want to have a series of increasingly far out treatments tried on me until I either get better or die.  In the likely case that the treatments don’t work, useful knowledge about their toxicity or lack of efficacy will have been obtained.  If one of them does, I get to blog about it.

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» Had to Happen: Right To Die from The Post Money Value
I track/read a fair number of blogs and I've been amazed that, so far, nobody has said anything about what's happening in Florida. Until now, that is. Tom Evslin has a blog entry with his thoughts on the whole right to die issue. For the [Read More]

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